Organization
JOURNEY THERAPEUTIC SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONNY RAY BRANDON LCSW, LADC (OWNER/CEO)
(405) 264-3686
Entity
Organization
Contact information
Practice address
517 N MAIN ST, ADA, OK 74820-9501
(405) 264-3686
Mailing address
304 DOLLINA DR, NORMAN, OK 73069-7570
(405) 264-3686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4165
OK
Other
Enumeration date
06/05/2013
Last updated
06/05/2013
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